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OBJECTIVES/SPECIFIC AIMS: Thionamides are anti-thyroid drugs (ATD) that are commonly used to treat autonomous thyrotoxicosis. Although efficacious, these medications carry a risk of neutropenia or agranulocytosis in a small but finite proportion of the patients who receive them. Some risk factors for thionamide-induced neutropenia have been identified, including body mass index (BMI) and dose, but the role of race and ethnicity in the pathogenesis of this potentially life-threatening side effect is not known. We hypothesize that there will be no effect of race or ethnicity on the change in absolute neutrophil count (ANC) following initiation of thionamide therapy among adult patients with thyrotoxicosis. METHODS/STUDY POPULATION: Data from the electronic medical record at UNM HSC were obtained using a standard database query for the years 2000–2016. Inclusion criteria were the prescription of an ATD, an ANC recorded within 30 days of initiating ATD therapy (pre-ATD), and an ANC recorded between 75 and 365 days after starting an ANC (post-ATD). Patients taking other agents known to cause neutropenia and agranulocytosis, such as clozapine, allopurinol, or chemotherapy, were excluded. Patients were assigned to racial and ethnic groups as follows: Hispanic, non-Hispanic Caucasian (NHC), native American, Black, and Asian. The post-ATD ANC was defined as the nadir ANC observed after the ATD was started. “Delta ANC” was defined as [(post-ATD ANC)−(pre-ATD ANC)]. ANOVA analysis with Bonferroni-adjusted post-hoc testing was performed to examine differences in the mean changes of ANC across ethnic groups. RESULTS/ANTICIPATED RESULTS: In total, 123 adult patients met inclusion and exclusion criteria and were included in the analysis. No significant difference was found between any of the racial groups with regard to age, sex, BMI, pre-ATD ANC, or the pre-ATD to post-ATD ANC interval. The native American group showed a significantly greater post-ATD ANC (not shown) and Delta-ANC as compared with the other groups. Delta ANC Hispanic=−1.4±3.3, Caucasian=−0.6±3.3, Black=−0.9±4.1, Asian=−3.8±4.8, native American=3.6±5.1 (all units per mm3; p<0.001). DISCUSSION/SIGNIFICANCE OF IMPACT: In this cohort of New Mexicans with thyrotoxicosis, native American race was protective against thionamide-induced neutropenia.

Native Americans in the Pennsylvania School Curriculum

In the 2000 U. S. Census, 18,348 people in Pennsylvania indicated that they were Native Americans, an increase of nearly 50% since 1990; another 34,302 identified themselves as "part-Indian." These numbers likely reflect a trend towards a greater acceptance of Native American status in the United States generally and in Pennsylvania in particular. This trend has been going on since the 1960s with the rise of the Red Power movement, and a changing American society that increasingly saw Native Americans as environmentally friendly and historically wronged. Today, in Pennsylvania, hardly a weekend goes by without a powwow or a tribal gathering somewhere in the state. In our on-going research with Pennsylvania's Native Americans since 2004, we have found them to be both proud of their identity and heritage and increasingly frustrated with the lack of recognition they receive from the state and the larger, non-Indian population. Pennsylvania is one of very few states that neither contains a reservation nor officially recognizes any Native American group. No university-level Native American cultural center or studies program exists within the state, and no state agency is dedicated to the issues and concerns of Native Americans. This is ironic because the first two hundred years of European history in Pennsylvania is one of extensive interaction, cooperation and eventually conflict with Native Americans. But, as will be seen in this paper, Native Americans have largely disappeared from the state history books.

Dialect Identity in a Tri-Ethnic Context

This study examines the development of a Native American Indian variety of English in the context of a rural community in the American South where European Americans, African Americans and Native American Indians have lived together for a couple of centuries now. The Lumbee Native American Indians, the largest Native American group east of the Mississippi River and the largest group in the United States without reservation land, lost their ancestral language relatively early in their contact with outside groups, but they have carved out a unique English dialect niche which now distinguishes them from cohort European American and African American vernaculars. Processes of selective accommodation, differential language change and language innovation have operated to develop this distinct ethnic variety, while their cultural isolation and sense of "otherness" in a bi-polar racial setting have served to maintain its ethnic marking.

Tribal and Agency Strategies for Assessing Impacts

The major elements required for human survival—earth, wind (air), fire, and water—are often central components in activities that can be categorized as religious, or at least of significant cultural value. On a bluff where a Native American group may have camped ten thousand years ago to survey the landscape and watch for buffalo, a modern community might like to install a picnic ground and, in the process, would likely disturb artifacts from the prehistoric occupants of the site. On a river characterized by rapids and waterfalls where a Native American group may have gone for spiritual empowerment and enrichment over the last two thousand years, a modern entrepreneur might like to construct a facility for power generation. In a volcano worshipped for millennia as the source of creation and destruction by Native Hawaiians, a developer might seek to extract heat for electric power. It is not surprising that, because of the centrality of the four elements in both biological and cultural survival, these valued resources become foci of political mobilization.